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Miliary Toxoplasmic Retinitis in Acquired Immunodeficiency Syndrome

Miliary Toxoplasmic Retinitis in Acquired Immunodeficiency Syndrome Abstract • A unique pattern of bilateral miliary retinitis due to ocular toxoplasmosis developed in a patient in the late stages of acquired immunodeficiency syndrome. Results of serologic tests for toxoplasmosis remained negative throughout the clinical course of his ocular disease. The retinitis was unresponsive to a brief course of antitoxoplasmosis therapy. At autopsy, the histopathologic material was consistent with toxoplasmic retinitis and the DNA polymerase chain reaction was positive for toxoplasmosis. Recognition of this pattern of retinitis is important in the appropriate treatment of immunosuppressed patients with retinitis. References 1. Friedman AH. The retinal lesions of the acquired immune deficiency syndrome . Trans Am Ophthalmol Soc . 1984;82:447. 2. Freeman WR, Stern WH, Gross JG, Taylor PB, Nadel AJ, Wiley CA. Pathologic observations made by retinal biopsy . Retina . 1990;10:195-204.Crossref 3. Freeman WR, Wiley CA, Gross JG, Thomas EL, Rao NA, Liggett PE. Endoretinal biopsy in immuno-suppressed patients: indications, utility and techniques . Ophthalmology . 1989;96:1559-1565.Crossref 4. Doft BH, Gass JDM. Punctate outer retinal toxoplasmosis . Arch Ophthalmol . 1985;103:1332-1336.Crossref 5. Matthews JD, Weiter JJ. Outer retinal toxoplasmosis . Ophthalmology . 1988;95:941-946.Crossref 6. Holland GN, Engstrom RE Jr, Glasgow BJ, et al. Ocular toxoplasmosis in patients with the acquired immuno-deficiency syndrome . Am J Ophthalmol . 1988;106:653-667. 7. Nicholson DH, Wolchoke B. Ocular toxoplasmosis in an adult receiving long-term corticosteroid therapy . Arch Ophthalmol . 1976;94:248-254.Crossref 8. Saiki RK, Gelfand DH, Stoffel S, et al. Primer-directed enzymatic amplification of DNA with a thermostable DNA polymerase . Science . 1988;139:487-491.Crossref 9. Wright DK, Manos MM. Sample preparation from paraffin-embedded tissues . In: Innis MA, Gelfand DH, Sninsky JJ, White TJ, eds. PCR Protocols . Orlando, Fla: Academic Press Inc; 1990:153-158. 10. Boothroyd JC, Burg JL, Nagel S, et al. Antigen and tubulin genes of Toxoplasma gondii . In: Agabian N, Goodman H, Nogueira N, eds. Molecular Strategies of Parasite Invasion . New York, NY: Alan R Liss Inc; 1987:237-250. 11. Brezin A, Egwuagu CE, Burnier M, et al. Identification of Toxoplasma gondii in paraffin-embedded sections by the polymerase chain reaction . Am J Ophthalmol . 1990;110:599-604. 12. Foster RE, Gutman FA, Meyers SM, Lowder CY. Acute multifocal inner retinitis . Am J Ophthalmol . 1991;111:673-681. 13. Jampol LM, Sieving PA, Pugh D, Fishman GA, Gilbert H. Multiple evanescent white-dot syndrome . Arch Ophthalmol . 1984;102:671-674.Crossref 14. Watzke RC, Packer JJ, Folk JC, Benson WE, Burgess D, Ober RR. Punctate inner choroidopathy . Am J Ophthalmol . 1984;98:572-584. 15. Dreyer RF, Gass JDM. Multifocal choroiditis and panuveitis: a syndrome that mimics ocular histoplasmosis . Arch Ophthalmol . 1984;102:1776-1784.Crossref 16. Gass JDM. Acute posterior multifocal placoid pigment epitheliopathy . Arch Ophthalmol . 1968;80:177-185.Crossref 17. Ryan SJ, Maumenee AE. Birdshot retinochoroidopathy . Am J Ophthalmol . 1980;89:31-45. 18. Parke DW, Font RL. Diffuse toxoplasmic retino-choroiditis in a patient with AIDS . Arch Ophthalmol . 1986;104:571-576.Crossref 19. Grossniklaus HE, Specht CS, Allaire G, Leavitt JA. Toxoplasma gondii retinochoroiditis and optic neuritis in acquired immune deficiency syndrome: report of a case . Ophthalmology . 1990;97:1342-1346.Crossref 20. Ruskin J, Remington JS. Toxoplasmosis in the compromised host . Ann Intern Med . 1976;84:193-199.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Miliary Toxoplasmic Retinitis in Acquired Immunodeficiency Syndrome

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Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1993.01090030091046
Publisher site
See Article on Publisher Site

Abstract

Abstract • A unique pattern of bilateral miliary retinitis due to ocular toxoplasmosis developed in a patient in the late stages of acquired immunodeficiency syndrome. Results of serologic tests for toxoplasmosis remained negative throughout the clinical course of his ocular disease. The retinitis was unresponsive to a brief course of antitoxoplasmosis therapy. At autopsy, the histopathologic material was consistent with toxoplasmic retinitis and the DNA polymerase chain reaction was positive for toxoplasmosis. Recognition of this pattern of retinitis is important in the appropriate treatment of immunosuppressed patients with retinitis. References 1. Friedman AH. The retinal lesions of the acquired immune deficiency syndrome . Trans Am Ophthalmol Soc . 1984;82:447. 2. Freeman WR, Stern WH, Gross JG, Taylor PB, Nadel AJ, Wiley CA. Pathologic observations made by retinal biopsy . Retina . 1990;10:195-204.Crossref 3. Freeman WR, Wiley CA, Gross JG, Thomas EL, Rao NA, Liggett PE. Endoretinal biopsy in immuno-suppressed patients: indications, utility and techniques . Ophthalmology . 1989;96:1559-1565.Crossref 4. Doft BH, Gass JDM. Punctate outer retinal toxoplasmosis . Arch Ophthalmol . 1985;103:1332-1336.Crossref 5. Matthews JD, Weiter JJ. Outer retinal toxoplasmosis . Ophthalmology . 1988;95:941-946.Crossref 6. Holland GN, Engstrom RE Jr, Glasgow BJ, et al. Ocular toxoplasmosis in patients with the acquired immuno-deficiency syndrome . Am J Ophthalmol . 1988;106:653-667. 7. Nicholson DH, Wolchoke B. Ocular toxoplasmosis in an adult receiving long-term corticosteroid therapy . Arch Ophthalmol . 1976;94:248-254.Crossref 8. Saiki RK, Gelfand DH, Stoffel S, et al. Primer-directed enzymatic amplification of DNA with a thermostable DNA polymerase . Science . 1988;139:487-491.Crossref 9. Wright DK, Manos MM. Sample preparation from paraffin-embedded tissues . In: Innis MA, Gelfand DH, Sninsky JJ, White TJ, eds. PCR Protocols . Orlando, Fla: Academic Press Inc; 1990:153-158. 10. Boothroyd JC, Burg JL, Nagel S, et al. Antigen and tubulin genes of Toxoplasma gondii . In: Agabian N, Goodman H, Nogueira N, eds. Molecular Strategies of Parasite Invasion . New York, NY: Alan R Liss Inc; 1987:237-250. 11. Brezin A, Egwuagu CE, Burnier M, et al. Identification of Toxoplasma gondii in paraffin-embedded sections by the polymerase chain reaction . Am J Ophthalmol . 1990;110:599-604. 12. Foster RE, Gutman FA, Meyers SM, Lowder CY. Acute multifocal inner retinitis . Am J Ophthalmol . 1991;111:673-681. 13. Jampol LM, Sieving PA, Pugh D, Fishman GA, Gilbert H. Multiple evanescent white-dot syndrome . Arch Ophthalmol . 1984;102:671-674.Crossref 14. Watzke RC, Packer JJ, Folk JC, Benson WE, Burgess D, Ober RR. Punctate inner choroidopathy . Am J Ophthalmol . 1984;98:572-584. 15. Dreyer RF, Gass JDM. Multifocal choroiditis and panuveitis: a syndrome that mimics ocular histoplasmosis . Arch Ophthalmol . 1984;102:1776-1784.Crossref 16. Gass JDM. Acute posterior multifocal placoid pigment epitheliopathy . Arch Ophthalmol . 1968;80:177-185.Crossref 17. Ryan SJ, Maumenee AE. Birdshot retinochoroidopathy . Am J Ophthalmol . 1980;89:31-45. 18. Parke DW, Font RL. Diffuse toxoplasmic retino-choroiditis in a patient with AIDS . Arch Ophthalmol . 1986;104:571-576.Crossref 19. Grossniklaus HE, Specht CS, Allaire G, Leavitt JA. Toxoplasma gondii retinochoroiditis and optic neuritis in acquired immune deficiency syndrome: report of a case . Ophthalmology . 1990;97:1342-1346.Crossref 20. Ruskin J, Remington JS. Toxoplasmosis in the compromised host . Ann Intern Med . 1976;84:193-199.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Mar 1, 1993

References